Search results for: obesity

Authors: Boris Bajer, Andrea Havranova, Miroslav Vlcek, Richard Imrich, Adela Penesova

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Lifestyle interventions can prevent the deterioration of impaired glucose tolerance to manifest type 2 diabetes, and also prevent cardiovascular diseases, as it showed many studies (the Finnish Diabetes Prevention Study, Diabetes Prevention Program (DPP), . the China Da Qing Diabetes Prevention Study, etc.) Therefore the aim of our study was to compare the effect of intensified lifestyle intervention on cardiometabolic parameters. Methods: It is an ongoing randomized interventional clinical study (NCT02325804) focused on the reduction of body weight/fat. Intervention: hypocaloric diet (30% restriction of calories) and physical activity 150 minutes/week. Before and after 8 weeks of intervention all patients underwent complete medical examination (measurement of physical fitness, resting metabolic rate (RMR), body composition analysis, oral glucose tolerance test, parameters of lipid metabolism, and other cardiometabolic risk factors. Results: So far 39 patients finished the intervention. The average reduction of body weight was 6,8 + 4,9 kg (0-15 kg; p=0,0006), accompanied with significant reduction of body fat percentage (p ≤ 0,0001), amount of fat mass (p=0,03), waist circumference (p=0.02). Amount of lean mass and RMR remained unchanged. Heart rate (p=0,02), systolic and diastolic blood pressure was reduced (p=0,01 p=0,02 resp.) as well as insulin sensitivity was improved. Lipid parameters also changed - cholesterol, LDL decreased (p=0,05, p=0,04 resp.), while triglycerides showed tendency to decrease (p=0,055). Liver function improved, alanine aminotrasnferase (ALT) were reduced (p=0,01). Physical fitness significantly improved (as measure VO2 max (p=0,02). Conclusion: Results of our study are in line with previous results about the beneficial effect of intensive lifestyle changes on the reduction of cardiometabolic risk factors and improvement of liver function. Supported by grants APVV 15-0228; VEGA 2/0161/16

Keywords: obesity, weight loss, diet lipids, blood pressure, liver enzymes

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Authors: Vichai Tienthavorn

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Background: Recently, the patients of non-communicable diseases (NCDs) are increasing in Thailand; especially hypertension and diabetes. Hypertension and Diabetes patients were found to be of 3.7 million in 2008. The varieties of human behaviors have been extensively changed in health. Hence, Thai Government has a policy to reduce NCDs. Generally, primary care plays an important role in treatment using medical process. However, NCDs patients have not been decreased. Objectives: This study not only reduce the patient and mortality rate but also increase the quality of life, could apply in different areas and propose to be the national policy, effectively for a long term operation. Methods: Here we report that primary health care (PHC), which is a primary process to screening, rapidly seek the person's risk. The screening tool of the study was Vichai's 7 color balls model, the medical education tool to transfer knowledge from student health team to community through health volunteers, creating community engagement in terms of social participation. It was found that people in community were realized in their health and they can evaluate the level of risk using this model. Results: Projects implementation (2015) in Nong Lom Health Center in Phayao (target group 15-65 years, 2529); screening hypertension coveraged 99.01%, risk group (light green) was decreased to normal group (white) from 1806 to 1893, significant severe patient (red) was decreased to moderate (orange) from 10 to 5. Health Program in behaving change with best practice of 3Es (Eating, Exercise, Emotion) and 3Rs (Reducing tobacco, alcohol, obesity) were applied in risk group; and encourage strictly medication, investigation in severe patient (red). Conclusion: This is the first demonstration of knowledge transfer to community engagement by student, which is the sustainable education in PHC.

Keywords: non-communicable disease, surveillance control and prevention systems, community engagement, primary health care

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Authors: Amany Ragab, Nashwa Khairat Abousamra, Omayma Saleh, Asmaa Higazy

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Insulin resistance syndrome has been shown to be associated with many coagulation and fibrinolytic proteins and these associations suggest that some coagulation and fibrinolytic proteins have a role in atherothrombotic disorders. This study was conducted to determine the levels of some of the haemostatic parameters in subjects having metabolic syndrome and to correlate these values with the anthropometric and metabolic variables associated with this syndrome. The study included 46 obese non diabetic subjects of whom 28 subjects(group1) fulfilled the ATP III criteria of the metabolic syndrome and 18 subjects (group2) did not have metabolic syndrome as well as 14 lean subjects (group 3) of matched age and sex as a control group. Clinical and laboratory evaluation of the study groups stressed on anthropometric measurements (weight, height, body mass index, waist circumference, and sagittal abdominal diameter), blood pressure, and laboratory measurements of fasting plasma glucose, fasting insulin, serum lipids, tissue plasminogen activator (t-PA), antithrombin III activity (ATIII), protein C and von Willebrand factor (vWf) antigen. There was significant increase in the concentrations of t-PA and vWf antigens in subjects having metabolic syndrome (group 1) in comparison to the other groups while there were non-significant changes in the levels of protein C antigen and AT III activity. Both t-PA and vWf showed significant correlation with HOMA-IR as a measure of insulin sensitivity. The t-PA showed also significant correlation with most of the variables of metabolic syndrome including waist circumference, BMI, systolic blood pressure, fasting plasma glucose, fasting insulin, and HDL cholesterol. On the other hand, vWf showed significant correlations with fasting plasma glucose, fasting insulin and sagital abdominal diameter, with non-significant correlations with the other variables. Haemostatic and fibrinolytic parameters should be included in the features and characterization of the insulin resistance syndrome. t-PA and vWf antigens concentrations were increased in subjects with metabolic syndrome and correlated with the HOMA-IR measure of insulin sensitivity. Taking into consideration that both t-PA and vWf are mainly released from vascular endothelium, these findings could be an indicator of endothelial dysfunction in that group of subjects.

Keywords: insulin resistance, obesity, metabolic syndrome, coagulation

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Authors: A. Papachristou, A. Ntikoudi, L. Makris, V. Saridakis

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Introduction: More than 10 million people are imprisoned or detained worldwide. Figures from 2011-12 show that prison inmates are more likely than the general population to suffer from chronic or infectious diseases, while most inmates are overweight or obese, and more than a quarter have high blood pressure. In 2011/12, the proportion of prisoners reporting diabetes or hyperglycemia was 899 per 10,000 prisoners, almost double the 2004 figure (483 per 10,000). It is important to ensure that this population has access to the same standard of care as people outside prisons, as access to services should be need-based. Diabetes is a public health problem associated with increased morbidity and mortality worldwide. According to the International Diabetes Federation (IDF) in 2017, approximately 425 million people worldwide had diabetes. This number is expected to increase to 629 million by 2045. Poor management of diabetes in prisons can lead to poor blood sugar control and increase the risk of complications. Aim: The aim of this review was to systematically evaluate all the available literature on diabetes care in custodial settings. Methods: An extensive literature search was conducted through electronic databases (PubMed, Scopus and CINAHL) with the terms ‘custody’, ‘diabetes Mellitus, ‘detention centers and ‘chronic disease’. Articles published in English until September 2022, were included; no other criteria on publication dates were set. Results: Most of the studies mentioned a diabetes prevalence of approximately 10%, among other common chronic. Hypertension, obesity, smoking, sedentary lifestyle were the most common comorbidities associated with diabetes. Conclusion: Good glycemic control is fundamental to managing diabetes, and while many prisoners enter prison poorly, access to regular medication and meals, as well as exercise, offers the potential for improvement. Not being able to get help as quickly as in the past can be extremely stressful, and some prisoners may deliberately raise their blood sugar levels to avoid the risk of developing hypoglycemia, especially if they know they have had previous episodes of nocturnal hypoglycemia. Thus, appropriate training and resources are critical to providing quality care to incarcerated people with diabetes.

Keywords: custody, diabetes mellitus, detention centers, chronic disease

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Authors: Faiz N. K. Yusufi, Aquil Ahmed, Jamal Ahmad

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Diabetes in India is growing at an alarming rate and the complications caused by it need to be controlled. Coronary heart disease (CHD) is one of the complications that will be discussed for prediction in this study. India has the second most number of diabetes patients in the world. To the best of our knowledge, there is no CHD risk score for Indian type 2 diabetes patients. Any form of CHD has been taken as the event of interest. A sample of 750 was determined and randomly collected from the Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N.M.C., A.M.U., Aligarh, India. Collected variables include patients data such as sex, age, height, weight, body mass index (BMI), blood sugar fasting (BSF), post prandial sugar (PP), glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), systolic blood pressure (SBP), smoking, alcohol habits, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), physical activity, duration of diabetes, diet control, history of antihypertensive drug treatment, family history of diabetes, waist circumference, hip circumference, medications, central obesity and history of CHD. Predictive risk scores of CHD events are designed by cox proportional hazard regression. Model calibration and discrimination is assessed from Hosmer Lemeshow and area under receiver operating characteristic (ROC) curve. Overfitting and underfitting of the model is checked by applying regularization techniques and best method is selected between ridge, lasso and elastic net regression. Youden’s index is used to choose the optimal cut off point from the scores. Five year probability of CHD is predicted by both survival function and Markov chain two state model and the better technique is concluded. The risk scores for CHD developed can be calculated by doctors and patients for self-control of diabetes. Furthermore, the five-year probabilities can be implemented as well to forecast and maintain the condition of patients.

Keywords: coronary heart disease, cox proportional hazard regression, ROC curve, type 2 diabetes Mellitus

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Authors: R. S. Dinesh Madhavan, M. Logaraj

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Background: Recent studies have documented an increase in the risk of cardiovascular diseases (CVD) and a high rate of progression to hypertension in persons with pre hypertension. The risk factors for the growing burden of cardiovascular diseases especially hypertension, diabetes, overweight or obesity and waist hip ratio are increasing. Much study has not been done on cardiovascular risk factors associated with blood pressure (BP) among college students in Indian population. Objectives: The objective of our study was to estimate the prevalence of prehypertension among male students and to assess the association between prehypertension and risk factors for cardiovascular diseases. Material and Methods: A cross-sectional study was conducted among students of a university situated in the suburban area of Chennai. A total of 403 students was studied which included 200 medical and 203 engineering students. The information on selected socio-demographic variables were collected with the help of pre tested structured questionnaire. Measurements of height, weight, blood pressure and postprandial blood glucose were carried out as per standard procedure. Results: The mean age of the participants was 19.56 ± 1.67years. The mean systolic and diastolic blood pressure were 125.80±10.03 mm of Hg and 78.96 ±11.75mm of Hg. The average intake of fruits and vegetable per week were 4.34 ±3.47days and 6.55±4.39 days respectively. Use of smoke and smokeless tobacco were 27.3% and 3% respectively. About 30.3% of the students consume alcohol. Nearly 45.9 % of them did not practice regular exercise. About 29 % were overweight and 5.7% were obese, 24.8% were with waist circumference above 90 centimeters. The prevalence of pre hypertension and hypertension was 49.6% and 19.1% among male students. The prevalence of pre hypertension was higher in medical students (51.5%) compared to engineering students (47.8%). Higher risk of being pre hypertensive were noted above the age of 20 years (OR=4.32), fruit intake less than 3 days a week (OR= 1.03), smokers (OR= 1.13), alcohol intake (OR=1.56), lack of physical exercise (OR=1.90), BMI of more than 25 kg/m2 (OR=1.99). But statistically significant difference was noted between pre hypertensive and normotensive for age (p<0.0001), lack of physical exercise (p=0.004) and BMI (p=0.015). Conclusion: In conclusion nearly half of the students were pre hypertensive. Higher prevalence of smoking, alcohol intake, lack of physical exercise, overweight and increased waist circumference and postprandial blood sugar more than 140 mg/dl was noted among pre-hypertensive compared to normotensive.

Keywords: cardiovascular diseases, prehypertension, risk factors, undergraduate Students

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Authors: Shaik Asha Begum, S. Joshna Rani, Shaik Abdul Rahaman

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INTRODUCTION: Breast cancer is a disease that creates in breast cells. "KAP" study estimates the Knowledge, Attitude, and Practices of a local area. More than 1.5 million ladies (25% of all ladies with malignancy) are determined to have bosom disease consistently all through the world. Understanding the degrees of Knowledge, Attitude and Practice will empower a more effective cycle of mindfulness creation as it will permit the program to be custom-made all the more properly to the necessities of the local area. OBJECTIVES: The objective of this study is to assess the knowledge on signs and symptoms, risk factors, provide awareness on the practicing of the early detection techniques of breast cancer and provide knowledge on the overall breast cancer including preventive techniques. METHODOLOGY: This is an expressive cross-sectional investigation. This investigation of KAP was done in the Nirmala Educational Institutions from January to April 2021. A total of 300 participants are included from women students in pharmacy graduates & lecturers, and also from graduates other than the pharmacy. The examiners are taken from the BCAM (Breast Cancer Awareness Measure), tool compartment (Version 2). RESULT: According to the findings of the study, the majority of the participants were not well informed about breast cancer. A lump in the breast was the most commonly mentioned sign of breast cancer, followed by pain in the breast or nipple. The percentage of knowledge related to the breast cancer risk factors was also very less. The correct answers for breast cancer risk factors were radiation exposure (58.20 percent), a positive family history (47.6 percent), obesity (46.9 percent), a lack of physical activity (43.6 percent), and smoking (43.2 percent). Breast cancer screening, on the other hand, was uncommon (only 30 and 11.3 percent practiced clinical breast examination and mammography respectively). CONCLUSION: In this study, the knowledge on the signs and symptoms, risk factors of breast cancer - pharmacy graduates have more knowledge than the non-pharmacy graduates but in the preventive techniques and early detective tools of breast cancer -had poor knowledge in the pharmacy and non-pharmacy graduate. After the awareness program, pharmacy and non-pharmacy graduates got supportive knowledge on the preventive techniques and also practiced the early detective techniques of breast cancer.

Keywords: breast cancer, mammography, KAP study, early detection

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Authors: Mesih Kocamuftuoglu, Gonca Ozan, Enver Ozan, Nalan Kaya, Sema Temizer Ozan

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Metabolic Syndrome, one of the common metabolic disorder, occurs with co-development of insulin resistance, obesity, dislipidemia and hypertension problems. Insulin resistance appears to play a pathogenic role in the metabolic syndrome. Also, there is a relationship between insulin resistance and infertility as known. Turmeric (Curcuma longa L.) a polyphenolic chemical is widely used for its coloring, flavoring, and medicinal properties, and exhibits a strong antioxidant activity. In this study, we assess the effects of turmeric on rat uterine tissue in metabolic syndrome model induced by high fructose diet. Thirty-two adult female Wistar rats weighing 220±20 g were randomly divided into four groups (n=8) as follows; control, fructose, turmeric, and fructose plus turmeric. Metabolic syndrome was induced by fructose solution 20% (w/v) in tap water, and turmeric (C.Longa) administered at the dose of 80 mg/kg body weight every other day by oral gavage. After the experimental period of 8 weeks, rats were decapitated, serum and uterine tissues were removed. Serum lipid profile, glucose, insülin levels were measured. Uterine tissues were fixed for histological analyzes. The uterine tissue sections were stained with hematoxylin-eosin (H & E) stain, then examined and photographed on a light microscope (Novel N-800Mx20). As a result, fructose consumption effected serum lipids, insulin levels, and insulin resistance significantly. Endometrium and myometrium layers were observed in normal structure in control group of uterine tissues. Perivascular edema, peri glandular fibrosis, and inflammatory cell increase were detected in fructose group. Sections of the fructose plus turmeric group showed a significant improvement in findings when compared to the fructose group. Turmeric group cell structures were observed similar with the control group. These results demonstrated that high-fructose consumption could change the structure of the uterine tissue. On the other hand, turmeric administration has beneficial effects on uterine tissue at that dose and duration when administered with fructose.

Keywords: metabolic syndrome, rat, turmeric, uterus

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Authors: Arman Kishan, Sanjay Kubsad, Steve Li, Mark Haft, Duc Nguyen, Dawn Laporte

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Objective: Carpal tunnel syndrome can be managed surgically with endoscopic or open carpal tunnel release (CTR). Rheumatoid arthritis (RA) is a known risk factor for Carpal Tunnel Syndrome (CTS) and is believed to be related to compression of the median nerve secondary to inflammation. We aimed to analyze national trends, outcomes, and patient-specific comorbidities associated with ECTR and OCTR in patients with RA. Methods: A retrospective cohort study was conducted using the PearlDiver database, identifying 683 RA patients undergoing ECTR and 4234 undergoing OCTR between 2010 and 2014. Demographic data, comorbidities, and complication rates were analyzed. Univariate and multivariable analyses assessed differences between the treatment methods. Results:  Patients with RA undergoing ECTR in comparison to OCTR had no significant differences in medical comorbidities such as hypertension, obesity, chronic kidney disease, hypothyroidism and diabetes mellitus. Patients in the ECTR group reported a risk ratio of 1.44 (95%CI: 1.10-1.89, p=0.01) of requiring repeat procedures within 90 days of the initial procedure. Five-year trends in ECTR and OCTR procedures reported a combined annual growth rate of 5.6% and 13.15, respectively. Conclusion: Endoscopic and open approaches to CTR are important considerations in surgical planning. RA and ECTR have previously been identified as independent risk factors for revision CTR. Our study has identified the 90-day risk of repeat procedures to be elevated in the ECTR group in comparison to the OCTR group. Additionally, the growth of OCTR procedures has outpaced the growth of ECTR procedures in the same period, likely in response to the trend of ECTR leading to higher rates of repeat procedures. The need for revision following ECTR in patients with RA could be related to chronic inflammation leading to transverse carpal ligament thickening and concomitant tenosynovitis. Future directions could include further characterization of repeat procedures performed in this subset of patients. 

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, rheumatoid arthritis, trends analysis, carpal tunnel syndrome

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Authors: Manuela Amorim, Cláudia S. Marques, Maria Conceição Calhau, Hélder J. Pinheiro, Maria Manuela Pintado

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Recently it has been recognized peptides from different food sources with biological activities. However, no relevant study has proven the potential of brewer yeast peptides in the modulation of gut microbiota. The importance of human intestinal microbiota in maintaining host health is well known. Probiotics, prebiotics and the combination of these two components, can contribute to support an adequate balance of the bacterial population in the human large intestine. The survival of many bacterial species inhabiting the large bowel depends essentially on the substrates made available to them, most of which come directly from the diet. Some of these substrates can be selectively considered as prebiotics, which are food ingredients that can stimulate beneficial bacteria such as Lactobacilli or Bifidobacteria growth in the colon. Moreover, conventional food can be used as vehicle to intake bioactive compounds that provide those health benefits and increase people well-being. In this way, the main objective of this work was to study the potential prebiotic activity of brewer yeast peptide extract (BYP) obtained via hydrolysis of yeast proteins by cardosins present in Cynara cardunculus extract for possible use as a functional ingredient. To evaluate the effect of BYP on the modulation of gut microbiota in diet-induced obesity model, Wistar rats were fed either with a standard or a high-fat diet. Quantified via 16S ribosomal RNA (rRNA) expression by quantitative PCR (qPCR), genera of beneficial bacteria (Lactobacillus spp. and Bifidobacterium spp.) and three main phyla (Firmicutes, Bacteroidetes and Actinobacteria) were assessed. Results showed relative abundance of Lactobacillus spp., Bifidobacterium spp. and Bacteroidetes was significantly increased (P < 0.05) by BYP. Consequently, the potential health-promoting effects of WPE through modulation of gut microbiota were demonstrated in vivo. Altogether, these findings highlight the possible intervention of BYP as gut microbiota enhancer, promoting healthy life style, and the incorporation in new food products, leads them bringing associated benefits endorsing a new trend in the improvement of new value-added food products.

Keywords: functional ingredients, gut microbiota, prebiotics, brewer yeast peptide extract

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Authors: Preetham Shankapal, Jill King, Kori Murray, Corby Martin, Paula Giselman, Jason Hicks, Owen Carmicheal

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Activation of reward and satiety networks in the brain while processing palatable food cues, as well as functional connectivity during rest has been studied using functional Magnetic Resonance Imaging of the brain in various obesity phenotypes. However, functional connectivity within the reward and satiety network during food cue processing is understudied. 14 obese individuals underwent two fMRI scans during viewing of Macronutrient Picture System images. Each scan included two blocks of images of High Sugar/High Fat (HSHF), High Carbohydrate/High Fat (HCHF), Low Sugar/Low Fat (LSLF) and also non-food images. Seed voxels within seven food reward relevant ROIs: Insula, putamen and cingulate, precentral, parahippocampal, medial frontal and superior temporal gyri were isolated based on a prior meta-analysis. Beta series correlation for task-related functional connectivity between these seed voxels and the rest of the brain was computed. Voxel-level differences in functional connectivity were calculated between: first and the second scan; individuals who saw novel (N=7) vs. Repeated (N=7) images in the second scan; and between the HC/HF, HSHF blocks vs LSLF and non-food blocks. Computations and analysis showed that during food image viewing, reward network ROIs showed significant functional connectivity with each other and with other regions responsible for attentional and motor control, including inferior parietal lobe and precentral gyrus. These functional connectivity values were heightened among individuals who viewed novel HS/HF images in the second scan. In the second scan session, functional connectivity was reduced within the reward network but increased within attention, memory and recognition regions, suggesting habituation to reward properties and increased recollection of previously viewed images. In conclusion it can be inferred that Functional Connectivity within reward network and between reward and other brain regions, varies by important experimental conditions during food photography viewing, including habituation to shown foods.

Keywords: fMRI, functional connectivity, task-based, beta series correlation

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Authors: Anjana Aggarwal, Sheilja Walia

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Prevalence of obesity and overweight is increasing due to sedentary lifestyles and busy schedules of people that spend less time on physical exercise. To reduce weight, people are finding easier and more convenient ways. The easiest solution is the use of dietary supplements and fat burners. These are products that decrease body weight by increasing the basal metabolic rate. Various reports have been published on the consumption of fat burners leading to heart palpitations, seizures, anxiety, depression, psychosis, bradycardia, insomnia, muscle contractions, hepatotoxicity, and even liver failure. Case reports and series are reporting that the ingredients present in the fat burners caused acute liver failure (ALF) and hepatic toxicity in many cases. Another contributing factor is the absence of regulations from the Food and Drug Administration on these products, leading to increased consumption and a higher risk of liver diseases among the population. This systematic review aims to attain a better understanding of the dietary supplements used globally to reduce weight and document the case reports/series of acute liver failure caused by the consumption of fat burners. Electronic databases like PubMed, Cochrane, Google Scholar, etc., will be systematically searched for relevant articles. Various websites of dietary products and brands that sell such supplements, Journals of Hepatology, National and international projects launched for ALF, and their reports, along with the review of grey literature, will also be done to get a better understanding of the topic. After discussing with the co-author, the selection and screening of the articles will be performed by the author. The studies will be selected based on the predefined inclusion and exclusion criteria. The case reports and case series that will be included in the final list of the studies will be assessed for methodological quality using the CARE guidelines. The results from this study will provide insights and a better understanding of fat burners. Since the supplements are easily available in the market without any restrictions on their sale, people are unaware of their adverse effects. The consumption of these supplements causes acute liver failure. Thus, this review will provide a platform for future larger studies to be conducted.

Keywords: acute liver failure, dietary supplements, fat burners, weight loss supplements

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Authors: Ashu Rastogi, Uttam Thakur, Jimmy Pathak, Rajesh Gupta, Anil Bhansali

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Introduction: Liraglutide is known to induce weight loss and metabolic benefits in obese individuals. However, its effect after sleeve gastrectomy are not known. Methods: People with obesity (BMI>27.5 kg/m2) underwent LSG. Subsequently, participants were randomized to receive either 0.6mg liraglutide subcutaneously daily from 6 week post to be continued till 24 week (L-L group) or placebo (L-P group). Patients were assessed before surgery (baseline) and 6 weeks, 12weeks, 18weeks and 24weeks after surgery for height, weight, waist and hip circumference, BMI, body fat percentage, HbA1c, fasting C-peptide, fasting insulin, HOMA-IR, HOMA-β, GLP-1 levels (after standard OGTT). MRI abdomen was performed prior to surgery and at 24weeks post operatively for the estimation of intrapancreatic and intrahepatic fat content. Outcome measures: Primary outcomes were changes in metabolic variables of fasting and stimulated GLP-1 levels, insulin, c-peptide, plasma glucose levels. Secondary variables were indices of insulin resistance HOMA-IR, Matsuda index; and pancreatic and hepatic steatosis. Results: Thirty-eight patients undergoing LSG were screened and 29 participants were enrolled. Two patients withdrew consent and one patient died of acute coronary event. 26 patients were randomized and data analysed. Median BMI was 40.73±3.66 and 46.25±6.51; EBW of 49.225±11.14 and 651.48±4.85 in the L-P and L-L group, respectively. Baseline FPG was 132±51.48, 125±39.68; fasting insulin 21.5±13.99, 13.15±9.20, fasting GLP-1 2.4± .37, 2.4± .32, AUC GLP-1 340.78± 44 and 332.32 ± 44.1, HOMA-IR 7.0±4.2 and 4.42±4.5 in the L-P and L-L group, respectively. EBW loss was 47± 13.20 and 65.59± 24.20 (p<0.05) in the placebo versus liraglutide group. However, we did not observe inter-group difference in metabolic parameters between the groups in spite of significant intra-group changes after 6 months of LSG. Intra-pancreatic fat prior to surgery was 3.21±1.7 and 2.2±0.9 (p=0.38) that decreased to 2.14±1.8 and 1.06±0.8 (p=0.25) at 6 months in L-P and L-L group, respectively. Similarly, intra-pancreatic fat was 1.97±0.27 and 1.88±0.36 (p=0.361) at baseline that decreased to 1.14±0.44 and 1.36±0.47 (p=0.465) at 6 months in L-P and L-L group, respectively. Conclusion: Liraglutide augments extra body weight loss after sleeve gastrectomy. A decrease in intra-pancreatic and intra-hepatic fat is noticed after bariatric surgery without additive benefit of liraglutide administration.

Keywords: sleeve gastrectomy, liraglutide, intra-pancreatic fat, insulin

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Authors: Rania F. Ahmed, Sally A. El Awdan, Gehad A. Abdel Jaleel, Dalia O. Saleh, Omar A. H. Ahmed-Farid

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The metabolic syndrome is an important public health concern often related to obesity, improper diet, and sedentary lifestyles and can predispose individuals to the development of many dangerous health conditions, disability and early death. This research aimed to investigate the efficacy of resveratrol (RSV) to reverse the neuro-complications associated with metabolic syndrome experimentally-induced in rats using an eight weeks high fat, high fructose diet (HFHF) model. The corresponding drug treatments were administered orally during the last 10 days of the diet. Behavioural tests namely the open field test (OFT) and the forced swimming test (FST) were conducted. Brain levels of monoamines viz. serotonin, norepinephrine and dopamine as well as their metabolites were assessed. 8-hydroxyguanosine (8-OHDG) as an indicative of DNA-fragmentation, nitric oxide (NOx) and tumor necrosis factor-α (TNF- α) were estimated. Finally, brain antioxidant parameters namely malondialdehyde (MDA), reduced and oxidized glutathione (GSH, GSSG) were evaluated. HFHF-induced metabolic syndrome resulted in decreased activity in the OFT and increased immobility duration in the FST. Furthermore, HFHF-induced metabolic syndrome lead to a significant increase in brain monoamines turn over as well as elevation in 8-OHDG, NOx, TNF- α, MDA and GSSG; and reduction in GSH. Ten days daily treatment with RSV (20 and 40 mg/kg p.o) dose dependently increased activity in the OFT and decreased immobility duration in the FST. Moreover, RSV normalized brain monoamines contents, reduced 8-OHDG, NOx, TNF- α, MDA and GSSG; and elevated GSH. In conclusion, we can say that RSV showed neuro-protective properties against HFHF-induced metabolic syndrome represented by monoamines preservation, prevention of neurodegeneration, anti-inflammatory and antioxidant potentials and could be recommended as a beneficial daily dietary supplement to treat the neuronal side effects associated with HFHF-induced metabolic syndrome.

Keywords: antioxidants, DNA-fragmentation, forced swimming test, HFHF-induced metabolic syndrome, monoamines, nitric oxide (NOx), open field, resveratrol, tumor necrosis factor-α (TNF- α), 8-hydroxyguanosine (8-OHDG)

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Authors: Bencharif Meriem, Sersar Ibrahim, Djaafri Zineb

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Introduction and purpose of the study: Education plays a fundamental role in the lives of young people, but what about their physical well-being as they spend long hours sitting at school? School inactivity is a problem that deserves particular attention because it can have significant repercussions on the health and development of students. The aim of this study was to describe and evaluate the physical activity of students in different practices in class, at recess and in the canteen. Material and methods: A physical activity diary and an anthropometric measurement sheet (weight, height) were provided to 123 school-aged adolescents. The measurements were carried out according to international recommendations. The statistical tests were carried out with the R software. 3.2.4. The significance threshold retained was 0.05. Results and Statistical Analysis: One hundred and twenty-three students agreed to participate in the study. Their average age was 16.5±1.60 years. Overweight was present in 8.13% and obesity in 4.06%. For the practice of physical activity, during physical education and sports classes, all students played sports with an average of 1.94±1.00 hours/week, of which 74.00% sweated or were out of breath during these hours of physical activity. It was also noted that boys practiced sports more than girls (p<0.0001). Each day, on average, students spent 39.78±37.85 min walking or running during recess. On the other hand, they spent, on average 4.25±2.65 hours sitting per day in class, at recess, in the canteen, etc., without counting the time spent in front of a screen. The increasing use of screens has become a major concern for parents and educators. On average, students spent approximately 42.90±38.41 min per day using screens in class, at recess, in the canteen and at home. (computer, tablet, telephone, video games, etc.) and therefore to a prolonged sedentary lifestyle. On average, students sat for more than 1.5 hours without moving for at least 2 minutes in a row approximately 1.72±0.71 times per day. Conclusion: These students spent many hours sitting at school. This prolonged inactivity can have negative consequences on their health, including problems with posture and cardiovascular health. It is crucial that schools, educators and parents collaborate to promote more active learning environments where students can move more and thus contribute to their overall well-being. It's time to rethink how we approach education and student health to give them a healthier, more active future.

Keywords: physical acivity, sedentarity, adolescents, school

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Authors: F. Moghtaderi, M. Burke, J. Troelsen

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There has been a significant decline in active travel as well as the massive increase use of car-dependent travel mode in many countries during past two decades. Evidential risks for people’s physical and mental health problems are followed by this increased use of motorized travel mode. These problems range from overweight and obesity to increasing air pollution. In response to these rising concerns, local councils and other interested organizations around the world have introduced a variety of initiatives regarding reduce the dominance of cars for the daily journeys. However, the nature of these kinds of interventions, which related to the human behavior, make lots of complexities. People’s travel behavior and changing this behavior, has two different aspects. People’s attitudes and perceptions toward the sustainable and healthy modes of travel, and motorized travel modes (especially private car use) is one these two aspects. The other one related to people’s behavior change processes. There are no comprehensive model in order to guide policy interventions to increase the level of succeed of such interventions. A comprehensive theoretical framework is required in accordance to facilitate and guide the processes of data collection and analysis to achieve the best possible guidelines for policy makers. Regarding this gaps in the travel behavior change research, this paper attempted to identify and suggest a multidimensional framework in order to facilitate planning interventions. A structured mixed-method is suggested regarding the expand the scope and improve the analytic power of the result according to the complexity of human behavior. In order to recognize people’s attitudes, a theory with the focus on people’s attitudes towards a particular travel behavior was needed. The literature around the theory of planned behavior (TPB) was the most useful, and had been proven to be a good predictor of behavior change. Another aspect of the research, related to the people’s decision-making process regarding explore guidelines for the further interventions. Therefore, a theory was needed to facilitate and direct the interventions’ design. The concept of the transtheoretical model of behavior change (TTM) was used regarding reach a set of useful guidelines for the further interventions with the aim to increase active travel and sustainable modes of travel. Consequently, a combination of these two theories (TTM and TPB) had presented as an appropriate concept to identify and design implemented travel behavior change interventions.

Keywords: behavior change theories, theoretical framework, travel behavior change interventions, urban research

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Authors: Li-Ching Lin, Yu-Tzu Dai

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Recurrent foot ulcers or foot amputation have a major impact on patients with diabetes mellitus (DM), medical professionals, and society. A critical procedure for foot care is foot self-monitoring. Medical professionals’ understanding of patients’ foot self-monitoring knowledge, attitude, and practice is beneficial for raising patients’ disease awareness. This study investigated these and related factors among patients with DM through a descriptive study of the correlations. A scale for measuring the foot self-monitoring knowledge, attitude, and practice of patients with DM was used. Purposive sampling was adopted, and 100 samples were collected from the respondents’ self-reports or from interviews. The statistical methods employed were an independent-sample t-test, one-way analysis of variance, Pearson correlation coefficient, and multivariate regression analysis. The findings were as follows: the respondents scored an average of 12.97 on foot self-monitoring knowledge, and the correct answer rate was 68.26%. The respondents performed relatively lower in foot health screenings and recording, and awareness of neuropathy in the foot. The respondents held a positive attitude toward self-monitoring their feet and a negative attitude toward having others check the soles of their feet. The respondents scored an average of 12.64 on foot self-monitoring practice. Their scores were lower in their frequency of self-monitoring their feet, recording their self-monitoring results, checking their pedal pulse, and examining if their soles were red immediately after taking off their shoes. Significant positive correlations were observed among foot self-monitoring knowledge, attitude, and practice. The correlation coefficient between self-monitoring knowledge and self-monitoring practice was 0.20, and that between self-monitoring attitude and self-monitoring practice was 0.44. Stepwise regression analysis revealed that the main predictive factors of the foot self-monitoring practice in patients with DM were foot self-monitoring attitude, prior experience in foot care, and an educational attainment of college or higher. These factors predicted 33% of the variance. This study concludes that patients with DM lacked foot self-monitoring practice and advises that the patients’ self-monitoring abilities be evaluated first, including whether patients have poor eyesight, difficulties in bending forward due to obesity, and people who can assist them in self-monitoring. In addition, patient education should emphasize self-monitoring knowledge and practice, such as perceptions regarding the symptoms of foot neurovascular lesions, pulse monitoring methods, and new foot self-monitoring equipment. By doing so, new or recurring ulcers may be discovered in their early stages.

Keywords: diabetic foot, foot self-monitoring attitude, foot self-monitoring knowledge, foot self-monitoring practice

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Authors: Sajad A. Rather, F. A. Masoodi, Rehana Akhter, S. M. Wani, Adil Gani

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Modern trend towards convenience foods has resulted in increased production and consumption of restructured meat products and are of great importance to the meat industry. In meat products fat plays an important role in cooking properties, texture & sensory scores, however, high fat contents in particular animal fats provide high amounts of saturated fatty acids and cholesterol and are associated with several types of non communicable diseases such as obesity, hypertension and coronary heart diseases. Thus, fat reduction has generally been seen as an important strategy to produce healthier meat products. This study examined the effects of reducing fat level from 20% to 10% and substituting mutton back fat with guar gum (0.5%, 1% & 1.5%) on cooking properties, proximate composition, lipid and protein oxidation, texture, microstructure and sensory characteristics of goshtaba- a traditional meat product of J & K, India were investigated and compared with high fat counterparts. Reduced- fat goshtaba samples containing guar gum had significantly (p ≤ 0.05) higher yield, less shrinkage, more moisture retention and more protein content than the control sample. TBARs and protein oxidation (carbonyl content) values of the control was significantly (p ≤ 0.05) higher than reduced fat goshtaba samples and showed a positive correlation between lipid and protein oxidation. Hardness, gumminess & chewiness of the control (20%) were significantly higher than reduced fat goshtaba samples. Microstructural differences were significant (p ≤ 0.05) between control and treated samples due to an increased moisture content in the reduced fat samples. Sensory evaluation showed significant (p ≤ 0.05) reduction in texture, flavour and overall acceptability scores of treatment products; however the scores for 0.5% and 1% treated samples were in the range of acceptability. Guar gum may also be used as a source of soluble dietary fibre in food products and a number of clinical studies have shown a reduction in postprandial glycemia and insulinemia on consumption of guar gum, with the mechanism being attributed to an increased transit time in the stomach and small intestine, which may have been due to the viscosity of the meal hindering the access of glucose to the epithelium.

Keywords: goshtaba, guar gum, traditional, fat reduction, acceptability

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Authors: Piotr Tylec, Julia Wierzbicka, Natalia Gajewska, Krzysztof Przeczek, Grzegorz Torbicz, Alicja Dudek, Magdalena Pisarska-Adamczyk, Mateusz Wierdak, Michal Pedziwiatr

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Introduction: Many patients have described changes in taste perception after weight loss surgery. However, little data is available about short term changes in taste after surgery. Aim: We aimed to evaluate short-term changes in taste preference after bariatric surgeries in comparison to colorectal surgeries. Material and Methods: Between April 2018 and April 2019, a total of 121 bariatric patients and 63 controls participated. Bariatric patients underwent laparoscopic sleeve gastrectomy or Roux-en-Y gastric by-pass. Controls underwent oncological colorectal surgeries. Patients who developed clinical complications requiring restriction of oral intake after surgery or withdraw their consent were excluded from the study. In the end, 85 bariatric patients and 44 controls were included. In all of them, the 16-item ERAS Protocol was applied. Using 10-points Numeric Rating Scale (1-10) patients completed questionnaire and rated their appetite and thirst (1 - no appetite/not thirsty, 10 – normal appetite/very thirsty) and flavoured standardized liquids' taste (1- horrible, 10-very tasty) and food images for the 6 group of taste (sweet, umami, sour, spicy, bitter and salty) (1 - not appetizing, 10 - very appetizing) preoperatively and on the first postoperative day. Data were analysed with Statistica 13.0 PL. Results: Analysed group consist of 129 patients (85 bariatric, 44 controls). Mean age and BMI in a research group was 44.91 years old, 46.22 kg/m² and in control group 62.09 years old, 25.87 kg/m², respectively. Our analysis revealed significant differences in changes of appetite between both groups (research: -4.55 ± 3.76 vs. control: -0.85 ± 4.37; p < 0.05), ratings bitter (research: 0.60 ± 2.98 vs. control: -0.88 ± 2.58; p < 0.05) and salty (research: 1.20 ± 3.50 vs. control: -0.52 ± 2.90; p < 0.05) flavoured liquids and ratings for sweet (research: 1.62 ± 3.31 vs. control: 0.01 ± 2.63; p < 0.05) and bitter (research: 1.21 ± 3.15 vs. control: -0.09 ± 2.25; p < 0.05) food images. There were statistically significant results in the ratings of other images, but in comparison to the control group, they were not statistically significant. Conclusion: The study showed that bariatric surgeries quickly decreases appetite and desire to eat certain types of food, such as salty. Moreover, the bitter taste was more desirable in the research group in comparison to control group. Nevertheless, the sweet taste was more appetible in the bariatric group than in control.

Keywords: bariatric surgery, general surgery, obesity, taste preference

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Authors: Youcef Amir

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The consumption of beverages continues to grow worldwide due to increasing demography, but pure fruit juices and high-quality nectars can induce protective effects on human health because of their natural bioactive components. In contrast, sodas and gaseous drinks containing synthetic food additives are considered as responsible for consumers of several pathologies such as obesity, diabetes, and non-alcoholic fatty liver disease. The nutritional and therapeutic virtues of fruit juices are generally a remarkable antioxidant power, anti-cancer activity linked to their richness of indigestible and indigestible sugars, vitamins, mineral salts, carotenoids and phenolic compounds. The main reasons, which led us to produce these fruit derivatives, are the non-availability of the fresh fruits mentioned above all along the year and also the existence of variations in the chemical composition of these different fruits as well as for the major or minor components. We tested, therefore, the physicochemical characteristics of each fruit juice and pulp apart and afterward those of the cocktails formulated. The fresh juices used during our experiments were obtained from the following fruits from north-central Algeria: prickly pear, pomegranate, melon, red oranges. The formulations of these fruit juices were tested after several trials comprising sensorial analysis, physicochemical factors (pH, titratable acidity, Brix degree, formal index, water content, total ash, total and reducing sugars, vitamin C, carotenoids, phenolic compounds) and microbial analysis after a storage period. To the pure juices proportions, citric acid E330, sucrose, and water were added followed by pasteurisation. These products were analysed from the physicochemical, microbial and sensorial viewpoints after a storage period of one month according to national legislation to evaluate their stability. The results of the physicochemical parameters of the prepared beverages had shown good physicochemical results, acceptable sensorial characteristics and microbial stability and safety before and after a storage period. We measured appreciable amounts of minor compounds with health properties.

Keywords: fruit juices, microbial analyses, nectars, physico chemical characteristics, sensorial analysis, storage period

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Authors: D. Maryama AG. Daud, Zuliana Bacho, Stephanie Chok, DG. Mashitah PG. Baharuddin, Mohd Hatta Tarmizi, Nathira Abdul Majeed, Helen Lasimbang

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Lifestyle, physical activity, food intake, genetics and medication are contributing factors for people getting obese. Which in some of the obese people were a low or non-responder to exercise. And obesity is very common clinical feature in women affected by Polycystic Ovarian Syndrome (PCOS). Labisia pumila var. alata (LP) is a local herb which had been widely used by Malay women in treating menstrual irregularities, painful menstruation and postpartum well-being. Therefore, this study was carried out to investigate the effect of LP with a structured exercise program on anthropometric, body composition and physical fitness performance of PCOS patients. By using a single blind and parallel study design, where by subjects were assigned into a 16-wk structured exercise program (3 times a week) interventions; (LP and exercise; LPE, and exercise only; E). All subjects in the LPE group were prescribed 200mg LP; once a day, for 16 weeks. The training heart rate (HR) was monitored based on a percentage of the maximum HR (HRmax) achieved during submaximal exercise test that was conducted at wk-0 and wk-8. The progression of aerobic exercise intensity from 25–30 min at 60 – 65% HRmax during the first week to 45 min at 75–80% HRmax by the end of this study. Anthropometric (body weight, Wt; waist circumference, WC; and hip circumference, HC), body composition (fat mass, FM; percentage body fat, %BF; Fat Free Mass, FFM) and physical fitness performance (push up to failure, PU; 1-minute Sit Up, SU; and aerobic step test, PVO2max) were measured at wk-0, wk-4, wk-8, wk-12, and wk-16. This study found that LP does not have a significant effect on body composition, anthropometric and physical fitness performance of PCOS patients underwent a structured exercise program. It means LP does not improve exercise responses of PCOS patients towards anthropometric, body composition and physical fitness performance. The overall data shows exercise responses of PCOS patients is by increasing their aerobic endurance and muscle endurance performances, there is a significant reduction in FM, PBF, HC, and Wt significantly. Therefore, exercise program for PCOS patients have to focus on aerobic fitness, and muscle endurance.

Keywords: polycystic ovarian syndrome, Labisia pumila var. alata, body composition, aerobic endurance, muscle endurance, anthropometric

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Authors: Nilgün Öztürk, Hakan Sabahtin Ali, Hülya Tuba Kıyan

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The genus Chenopodium belongs to Amaranthaceae, is represented by approximately 250 species in the world and 15 species and three subspecies in Turkey. Chenopodium species are traditionally used to treat chest and abdominal pain, shortness of breath, cough and neurological disorders. Chenopodium quinoa Willd. (Quinoa) is native to Andes region of South America (especially Peru and Bolivia) and cultivated in many countries include also Turkey in the world nowadays. The seeds of quinoa are rich in protein, and the phytochemical composition consists of antioxidant substances such as polyphenolic compounds, flavonoids, vitamins, and minerals; anticancer and neuroprotective compounds such as tocotrienols; anti-inflammatory compounds such as carotenoids and anthocyanins and also saponins and starch. Food products of quinoa such as quinoa cereal bar, pasta and cornflakes are used in the diet made during many disorders like obesity, cardiovascular disorder, hypertension and Celiac disease. Also quinoa seems to have antimicrobial, anti-inflammatory and cholesterol-lowering properties because of its bioactive compounds. In this present study, the aqueous ethanolic extracts of the seeds of three different coloured genotypes of quinoa were investigated for their antioxidant activities using 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity, ferrous ion-chelating effect, ferric-reducing antioxidant power, ABTS radical cation decolorization assays and total phenolic contents using Folin-Ciocalteu assay. Among the three genotypes of quinoa; the aqueous ethanolic extract of the red genotype had the highest total phenolic content (83.54 ± 2.12 mg gallic acid/100 g extract) whereas the extract of the white genotype had the lowest total phenolic content (70.66 ± 0.25 mg gallic acid/100 g). According to the antioxidant activity results; the extracts showed moderate reducing power effect whereas weak ABTS radical cation decolorization and ferrous ion-chelating effect and also too weak DPPH radical scavenging activity when compared to the positive standards.

Keywords: amaranthaceae, antioxidant activity, Chenopodium quinoa willd., total phenolic content

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Authors: Gabriela D. Silva, Rodrigo L. O. R. Cunha, Mauricio D. Coutinho-Neto

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In the last four decades the biological activities of selenium compounds has received great attention, particularly for hypervalent derivates from selenium (IV) used as enzyme inhibitors. The unregulated activity of cysteine proteases are related to the development of several pathologies, such as neurological disorders, cardiovascular diseases, obesity, rheumatoid arthritis, cancer and parasitic infections. These enzymes are therefore a valuable target for designing new small molecule inhibitors such as selenuranes. Even tough there has been advances in the synthesis and design of new selenuranes based inhibitors, little is known about their mechanism of action. It is a given that inhibition occurs through the reaction between the thiol group of the enzyme and the chalcogen atom. However, several open questions remain about the nature of the mechanism (associative vs. dissociative) and about the nature of the reactive species in solution under physiological conditions. In this work we performed a theoretical investigation on model systems to study the possible routes of substitution reactions. Nucleophiles may be present in biological systems, our interest is centered in the thiol groups from the cysteine proteases and the hydroxyls from the aqueous environment. We therefore expect this study to clarify the possibility of a route reaction in two stages, the first consisting of the substitution of chloro atoms by hydroxyl groups and then replacing these hydroxyl groups per thiol groups in selenuranes. The structures of selenuranes and nucleophiles were optimized using density function theory along the B3LYP functional and a 6-311+G(d) basis set. Solvent was treated using the IEFPCM method as implemented in the Gaussian 09 code. Our results indicate that hydrolysis from water react preferably with selenuranes, and then, they are replaced by the thiol group. It show the energy values of -106,0730423 kcal/mol for dople substituition by hydroxyl group and 96,63078511 kcal/mol for thiol group. The solvatation and pH reduction promotes this route, increasing the energy value for reaction with hydroxil group to -50,75637672 kcal/mol and decreasing the energy value for thiol to 7,917767189 kcal/mol. Alternative ways were analyzed for monosubstitution (considering the competition between Cl, OH and SH groups) and they suggest the same route. Similar results were obtained for aliphatic and aromatic selenuranes studied.

Keywords: chalcogenes, computational study, cysteine proteases, enzyme inhibitors

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Authors: Tanida Julvanichpong

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Exercise has been regarded as a necessary and important aspect to enhance physical performance and psychology health. Body weight statistics of students in junior high school students in Chonburi Province beyond a standard risk of obesity. Promoting exercise among Junior high school students in Chonburi Province, essential knowledge concerning factors influencing exercise is needed. Therefore, this study aims to (1) determine the levels of perceived exercise behavior, exercise behavior in the past, perceived barriers to exercise, perceived benefits of exercise, perceived self-efficacy to exercise, feelings associated with exercise behavior, influence of the family to exercise, influence of friends to exercise, and the perceived influence of the environment on exercise. (2) examine the predicting ability of each of the above factors while including personal factors (sex, educational level) for exercise behavior. Pender’s Health Promotion Model was used as a guide for the study. Sample included 652 students in junior high schools, Chonburi Provience. The samples were selected by Multi-Stage Random Sampling. Data Collection has been done by using self-administered questionnaires. Data were analyzed using descriptive statistics, Pearson’s product moment correlation coefficient, Eta, and stepwise multiple regression analysis. The research results showed that: 1. Perceived benefits of exercise, influence of teacher, influence of environmental, feelings associated with exercise behavior were at a high level. Influence of the family to exercise, exercise behavior, exercise behavior in the past, perceived self-efficacy to exercise and influence of friends were at a moderate level. Perceived barriers to exercise were at a low level. 2. Exercise behavior was positively significant related to perceived benefits of exercise, influence of the family to exercise, exercise behavior in the past, perceived self-efficacy to exercise, influence of friends, influence of teacher, influence of environmental and feelings associated with exercise behavior (p < .01, respectively) and was negatively significant related to educational level and perceived barriers to exercise (p < .01, respectively). Exercise behavior was significant related to sex (Eta = 0.243, p=.000). 3. Exercise behavior in the past, influence of the family to exercise significantly contributed 60.10 percent of the variance to the prediction of exercise behavior in male students (p < .01). Exercise behavior in the past, perceived self-efficacy to exercise, perceived barriers to exercise, and educational level significantly contributed 52.60 percent of the variance to the prediction of exercise behavior in female students (p < .01).

Keywords: predictive factors, exercise behaviors, Junior high school, Chonburi Province

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Authors: Ledi Neçaj

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Introduction: Cardio-respiratory rehabilitation is the set of coordinated interventions needed to provide the best physical, psychological, and social conditions so that patients with chronic or post-acute cardiopulmonary disease, with their efforts, maintain or resume optimal functioning in society through improved health behaviors. Purpose: To study the effectiveness of the application of Cardio-Respiratory Rehabilitation in the typology of patients with chronic or post-acute cardiomyopathy and chronic respiratory diseases in order to facilitate their therapeutic use and to improve the overall quality of life. Material and Method: This is a prospective study including patients with COPD and cardiac disease who were included in the rehabilitation program during the period January 2019 - November 2021. The study was conducted at the University Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of Good Counsel, Tirana". An individual chart was used to collect sociodemographic, physical, clinical, and functional examinations for each patient. Results: The study included 253 patients, with a mean age of 62.1 (± 7.9) years, ranging from 48 to 82 years. (67.6%) of the patients were males, and (32.4%) female. Male patients predominated in all age groups, with a statistically significant difference with females (p<0.01). The most common cardiac pathologies are coronary artery bypass (24%), cerebral stroke (9%), myocardial infarction (17%), Stent placement (8%) (p<0.01). Correlation matrix of risk factors found a significant correlation of alcohol consumption with diabetes, smoking, dyslipidemia, sedentary life, obesity, AVC, and hypertension. Functional capacity estimated by change in metabolic equivalents (MET) improved by 46% from 4. ±2.2 to 7.2± .8 METs (p<0.01). Duration of exercise after rehabilitation was increased by 21% compared to baseline (p<0.01). The mean score of all three subscales of the questionnaire: symptoms (p=0.03), activity (p<0.01), and impact (p<0.01) after rehabilitation, was lower compared to pre-rehabilitation. Conclusions: The rehabilitation program has impacted on improving the quality of life, reducing symptoms, reducing the impact of negative factors on daily life, and reducing dyspnea during daily activities.

Keywords: cardio-respiratory rehabilitation, physical exercise, quality of life, diseases

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Authors: Hoda M. Eid, Abir Nachar, Farah Thong, Gary Sweeney, Pierre S. Haddad

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Caffeic acid methyl ester (CAME) and caffeic ethyl esters (CAEE) were previously reported to potently stimulate glucose uptake in cultured C2C12 skeletal muscle cells via insulin-independent mechanisms involving the activation of adenosine monophosphate-activated protein kinase (AMPK). In the present study, we investigated the effect of the two compounds on the translocation of glucose transporter GLUT4 in L6 skeletal muscle cells. The cells were treated with the optimum non-toxic concentration (50 µM) of either CAME or CAEE for 18 h. Levels of GLUT4myc at the cell surface were measured by O-phenylenediamine dihydrochloride (OPD) assay. The effects of CAME and CAEE on GLUT1 and GLUT4 protein content were also measured by western immunoblot. Our results show that CAME and CAEE significantly increased glucose uptake, GLUT4 translocation and GLUT4 protein content. Furthermore, the effect of the two CA esters on two insulin-sensitive cell lines: H4IIE rat hepatoma and 3T3-L1 adipocytes were investigated. CAME and CAEE reduced the enzymatic activity of the key hepatic gluconeogenic enzyme glucose-6-phosphatase in a concentration-dependent manner. In addition, they exerted a concentration-dependent antiadipogenic effect on 3T3-L1 cells. Mitotic clonal expansion (MCE), a prerequisite for adipocytes differentiation was also concentration-dependently inhibited. The two compounds abrogated lipid droplet accumulation, blocked MCE and maintained cells in fibroblast-like state when applied at the maximum non-toxic concentration (100 µM). In addition, the expression of the early key adipogenic transcription factors CCAAT enhancer-binding protein beta (C/EBP-β) and the master regulator of adipogenesis peroxisome-proliferator-activated receptor gamma (PPAR-γ) were inhibited. We, therefore, conclude that CAME and CAEE exert pleiotropic benefits in several insulin-sensitive cell lines through insulin-independent mechanisms involving AMPK, hence they may treat obesity, diabetes and other metabolic diseases.

Keywords: type 2 diabetes mellitus, insulin resistance, GLUT4, Akt, AMPK.

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Authors: Syrus Zimaze, George Nsimbe, Valley Mugwanya, Matiya Lule, Edgar Watson, Patrick Gwayambadde

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Physical inactivity is a growing global epidemic, also recognised as a major public health challenge. Globally, there are alarming rates of children reported with cardiovascular disease and obesity with limited interventions. In Sub Saharan Africa, there is limited information about involvement in physical activity especially among children aged 6 to 18 years. The aim of this study was to explore factors associated with involvement in physical activity among children in Uganda. Methods: We included all parents with children aged 6 to 18 years training with Excel Soccer Academy between January 2017 and June 2018. Physical activity definition was time spent participating in routine soccer training at the academy for more than 30 days. Each child's attendance was recorded, and parents provided demographic and social economic data. Data on predictors of physical activity involvement were collected using a standardized questionnaire. Descriptive statistics and frequency were used. Binary logistic regression was used at the multi variable level adjusting for education, residence, transport means and access to information technology. Results: Overall 356 parents were interviewed; Boys 318 (89.3%) engaged more in physical activity than girls. The median age for children was 13 years (IQR:6-18) and 42 years (IQR:37-49) among parents. The median time spent at the Excel soccer academy was 13.4 months (IQR: 4.6-35.7) Majority of the children attended formal education, p < 0.001). Factors associated with involvement in physical activity included: owning a permanent house compared to a rented house (odds ratio [OR] :2.84: 95% CI: 2.09-3.86, p < 0.0001), owning a car compared to using public transport (OR: 5.64 CI: 4.80-6.63, p < 0.0001), a parent having received formal education compared to non-formal education (OR: 2.93 CI: 2.47-3.46, p < 0.0001) and daily access to information technology (OR:0.40 CI:0.25-0.66, p < 0.001). Parent’s age and gender were not associated to involvement in physical activity. Conclusions: Socioeconomic factors were positively associated with involvement in physical activity with boys participating more than girls in soccer activities. More interventions are required geared towards increasing girl’s participation in physical activity and those targeting children from less privilege homes.

Keywords: physical activity, Sub-Saharan Africa, social economic factors, children

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Authors: Agnieszka Rolinska, Marta Makara-Studzinska

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Introduction: In recent years, there has been an intensive development of research into the physiological relationships between the experienced stress and obesity. Moreover, strong chronic stress leads to the disorganization of a person’s activeness on various levels of functioning, including the behavioral and cognitive sphere (also in one’s diet). Aim: The present work addresses the following research questions: Is there a relationship between an increase in stress related to the disease and the need for the cyclicality of diabetologic education in gestational diabetes? Are there any differences in terms of the experienced stress during the last three months of pregnancy in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Are there any differences in terms of stress coping styles in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Method: The study involved pregnant women with gestational diabetes (treated with diet, without insulin therapy) and in normal pregnancy – 206 women in total. The following psychometric tools were employed: Perceived Stress Scale (PSS; Cohen, Kamarck, Mermelstein), Coping Inventory for Stressful Situations (CISS; Endler, Parker) and authors’ own questionnaire. Gestational diabetes mellitus was diagnosed on the basis of the results of fasting oral glucose tolerance test (75 g OGTT). Body weight measurements were confirmed in a diagnostic interview, taking into account medical data. Regularities in weight gains in pregnancy were determined according to the recommendations of the Polish Gynecological Society and American norms determined by the Institute of Medicine (IOM). Conclusions: An increase in stress related to the disease varies in patients with differing requirements for the cyclical nature of diabetologic education (i.e. education which is systematically repeated). There are no differences in terms of recently experienced stress and stress coping styles between women with gestational diabetes and those in normal pregnancy. There is a relationship between weight gains in pregnancy and the stress experienced in life as well as stress coping styles – both in pregnancy complicated by diabetes and in physiological pregnancy. In the discussion of the obtained results, the authors refer to scientific reports from English-language magazines of international range.

Keywords: diabetologic education, gestational diabetes, stress, weight gain in pregnancy

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Authors: Faiz N. K. Yusufi, Aquil Ahmed, Jamal Ahmad

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Predicting the risk of diabetic retinopathy (DR) in Indian type 2 diabetes patients is immensely necessary. India, being the second largest country after China in terms of a number of diabetic patients, to the best of our knowledge not a single risk score for complications has ever been investigated. Diabetic retinopathy is a serious complication and is the topmost reason for visual impairment across countries. Any type or form of DR has been taken as the event of interest, be it mild, back, grade I, II, III, and IV DR. A sample was determined and randomly collected from the Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N.M.C., A.M.U., Aligarh, India. Collected variables include patients data such as sex, age, height, weight, body mass index (BMI), blood sugar fasting (BSF), post prandial sugar (PP), glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), systolic blood pressure (SBP), smoking, alcohol habits, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), physical activity, duration of diabetes, diet control, history of antihypertensive drug treatment, family history of diabetes, waist circumference, hip circumference, medications, central obesity and history of DR. Cox proportional hazard regression is used to design risk scores for the prediction of retinopathy. Model calibration and discrimination are assessed from Hosmer Lemeshow and area under receiver operating characteristic curve (ROC). Overfitting and underfitting of the model are checked by applying regularization techniques and best method is selected between ridge, lasso and elastic net regression. Optimal cut off point is chosen by Youden’s index. Five-year probability of DR is predicted by both survival function, and Markov chain two state model and the better technique is concluded. The risk scores developed can be applied by doctors and patients themselves for self evaluation. Furthermore, the five-year probabilities can be applied as well to forecast and maintain the condition of patients. This provides immense benefit in real application of DR prediction in T2DM.

Keywords: Cox proportional hazard regression, diabetic retinopathy, ROC curve, type 2 diabetes mellitus

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Authors: Jillian Correia, Ali Sakkal

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Lunchtime can play a pivotal role in shaping student eating habits. Studies have previously indicated that eating a healthy meal during the school day can improve students’ well-being and academic performance, and potentially prevent childhood obesity. This study investigated the school lunch program in the United Kingdom in order to gain an understanding of the attitudes and beliefs surrounding school meals and the realities of student food patterns. Using a qualitative research methodology, this study was conducted in three primary and secondary school systems in London, United Kingdom. In depth interviews consisting of 14 headteachers, teachers, staff, and chefs and fieldwork observations of approximately 830 primary and secondary school students in the three schools’ cafeterias provided the data. The results of interview responses and fieldwork observation yielded the following set of themes: (a) school meals are publicly portrayed as healthful and nutritious, yet students’ eating habits do not align with this advertising, (b) the level of importance placed on school lunch varies widely among participants and generates inconsistent views concerning who is responsible (government, families, caterers, or schools) for students’ eating habits, (c) role models (i.e. teachers and chefs) present varying levels of interaction with students and conflicting approaches when monitoring students’ eating habits. The latter finding expanded upon Osowski, Göranzon, and Fjellström’s (2013) concept of teacher roles to formulate three education philosophies – the Removed Authority Role Model, the Accommodating Role Model, and the Social Educational Role Model – concluding that the Social Educational Role Model was the most effective at fostering an environment that encouraged healthy eating habits and positive behavior. For schools looking to cultivate strong relationships between students and teachers and facilitate healthier eating habits, these findings were used to construct three key recommendations: (1) elevate the lunch environment by encouraging proper dining etiquette, (2) get teachers eating at the table with students, and (3) shift the focus from monitoring behavior to a teacher-student dialogue centered on food awareness.

Keywords: food culture, eating habits, school meals, student behavior, education, food patterns, lunchtime

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